Provider Demographics
NPI:1396947776
Name:BROWN, STEVEN WALLACE (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:WALLACE
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1850 HICKORY ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-2325
Mailing Address - Country:US
Mailing Address - Phone:325-670-4730
Mailing Address - Fax:325-670-4736
Practice Address - Street 1:1850 HICKORY ST
Practice Address - Street 2:SUITE 101
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-2325
Practice Address - Country:US
Practice Address - Phone:325-670-4730
Practice Address - Fax:325-670-4736
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXN2015207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
BP3-0019377OtherINSTITUTIONAL PERMIT